Last week the government of Norway published a new national health strategy. In its 146 pages, the strategy document covers a wide range of health issues with the overarching goal of reducing health inequalities. Included in this plan is an articulation of Norway's new approach to tobacco and vaping.
Among the government's plans are:
- a new national smoking cessation program
- standardised packaging for e-cigarettes
- flavour restrictions on e-cigarettes
- banning on remote (e-sales) of tobacco and e-cigarettes
- restrictions on specialty shops in order to reduce their promotional impact.
- tobacco free generation for those born after 2010 (including e-cigarettes and snus).
- banning on smoking in private buildings with children, in outdoor playgrounds, sports area and in other common areas.
- higher taxes on tobacco products etc, and stronger cooperation between the health and customs authorities to address illegal tobacco imports,
- expanded public campaigns to encourage quitting and to prevent starting.
- advance implementation of FCTC Article 5.3 with "legislative support, information measures and guidelines" for public employees.
- expanded reporting requirements for tobacco companies and consideration for maximum limits for inhalants
- requirement for tobacco companies to pay for the costs of clean-up of tobacco waste.
- address advertising for tobacco and e-cigarettes in social media.
- requiring warnings on individual cigarettes
In developing this strategy, the Norwegian government has identified 6 main goals:
- Daily smoking and snus use will be below 5 per cent in all age and educational groups.
- Children born in 2010 and later will not use tobacco or related products
- Everyone who wishes to quit should be offered free help to do so.
- Access to tobacco products etc. will be substantially reduced to protect children and young people.
- No one should be bothered by secondhand smoke.
- The tobacco industry should not be able to influence tobacco policy, in line with our international obligations.
The plan "Folkehelsemeldinga Nasjonal strategi for utjamning av sosiale helseforskjellar" can be downloaded here.
The Norwegian context
Norway, like Canada, is a rich country with a mixed economy and a well-developed health care system. The population, at 5.6 million, is about the same as that of British Columbia. Norway, with its large market for snus products, has a long experience in "reduced harm" products.
Norway is not a member of the European Union, and has only recently agreed to align its policies with the EU Tobacco Directive. The transition is expected in 2023. E-cigarettes remain illegal in Norway, but will become legal when the transition to the EU directive is complete. Regulations are being prepared to support the transition.
Although Norway has roughly the same percentage of people who smoking cigarettes daily as in Canada (7% vs. 8.4%) it has a much higher proportion who smoke on an occasional basis (8% vs. 3.4%). As a result, the overall rates of current smoking are higher in Norway (16%) than in Canada (11.8%). Twenty years ago, the difference was much greater.
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Data from FHI and Statistics Canada (CCHS) |
As in Canada, the percentage of young people who smoke tobacco has fallen dramatically, but in Norway this has been accompanied by an increase in snus use, whereas in Canada it is e-cigarette use that has grown.
In Norway, the proportion of people who snus daily is higher than those who smoke daily: 1 in 5 men (21%) and 1 in 10 women (9%). Snus use is highest in the younger age groups.
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| Among Norwegian men, snus use is highest among young adults (16 to 24) |
Over-all past-month e-cigarette use is higher in Canada (5%) than in Norway (3%) - the illegal status of e-cigarettes in Norway will likely have contributed to this difference. Rates of e-cigarette use among young people in Norway remain low.
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| Unlike Canada, Young people in Norway are only slightly more likely to use e-cigarettes than older people. |
Further information from the Norwegian public health institute (FHI) on historic smoking and snus use can be found here.
